Description - DE Medical Assistance Program

J2469 PALONOSETRON HCL 3 $17.51
J2480 HYDROCHLORIDES OF OPIUM INJ O $0.00
J2490 INJECTION, PARALDEHYDE, UP TO 5 ML O $0.00
J2495 INJECTION, TRIDIHEXETHYL CHLORIDE P O $0.00
J2500 PARICALCITOL O $0.00
J2501 PARICALCITOL 5 $0.00
J2503 PEGAPTANIB SODIUM INJECTION 6 $0.00
J2504 PEGADEMASE BOVINE, 25 IU 3 $247.33
J2505 INJECTION, PEGFILGRASTIM 6MG 3 $2,364.70
J2510 PENICILLIN G PROCAINE INJ 5 $0.00
J2512 INJ PENTAGASTRIN PER 2 ML O $0.00
J2513 PENTASTARCH 10% SOLUTION 3 $13.05
J2515 PENTOBARBITAL SODIUM INJ 3 $12.24
J2520 INJECTION, THIOPENTAL SODIUM O $0.00
J2540 PENICILLIN G POTASSIUM INJ 3 $0.82
J2543 PIPERACILLIN/TAZOBACTAM 3 $6.10
J2545 PENTAMIDINE NON-COMP UNIT 9 $0.00
J2550 PROMETHAZINE HCL INJECTION 3 $1.35
J2560 PHENOBARBITAL SODIUM INJ 5 $0.00
J2562 PLERIXAFOR INJECTION 3 $222.83
J2590 OXYTOCIN INJECTION 5 $0.00
J2595 INJECTION, VASOPRESSIN TANNATE O $0.00
J2597 INJ DESMOPRESSIN ACETATE 5 $0.00
J2600 INJECTION, POSTERIOR PITUITARY, UP O $0.00
J2640 PREDNISOLONE SODIUM PH INJ O $0.00
J2650 PREDNISOLONE ACETATE INJ 5 $0.00
J2670 TOTAZOLINE HCL INJECTION 5 $0.00
J2672 INJECTION, PROPANTHELINE BROMIDE O $0.00
J2675 INJ PROGESTERONE PER 50 MG O $0.00
J2680 FLUPHENAZINE DECANOATE 25 MG 5 $0.00
J2690 PROCAINAMIDE HCL INJECTION 5 $0.00
J2700 OXACILLIN SODIUM INJECITON 3 $2.00
J2710 NEOSTIGMINE METHYLSLFTE INJ 6 $0.00
J2720 INJ PROTAMINE SULFATE/10 MG 5 $0.00
J2724 PROTEIN C CONCENTRATE 3 $11.79
J2725 INJ PROTIRELIN PER 250 MCG 5 $0.00
J2730 PRALIDOXIME CHLORIDE INJ 5 $0.00
J2760 PHENTOLAINE MESYLATE INJ 9 $0.00
J2765 METOCLOPRAMIDE HCL INJECTION 3 $1.30
J2770 QUINUPRISTIN/DALFOPRISTIN 5 $0.00
J2778 RANIBIZUMAB INJECTION 3 $404.64
J2780 RANITIDINE HYDROCHLORIDE INJ 3 $1.15
J2783 RASBURICASE 6 $0.00
J2785 REGADENOSON INJECTION 3 $50.85
J2788 RHO D IMMUNE GLOBULIN 50 MCG 3 $25.96
J2790 RHO D IMMUNE GLOBULIN INJ 3 $86.13
J2791 RHOPHYLAC INJECTION 3 $5.22
J2792 RHO(D) IMMUNE GLOBULIN H, SD 3 $18.57
J2793 RILONACEPT INJECTION 3 $23.29